Dáil Éireann Debate, Wednesday - 17 November 2004
141 Mr. Ring asked the Tánaiste and Minister for Health and Children if the State will pay for a person (details supplied) with a serious illness to obtain treatment outside this country; and if there is a scheme within the health boards or her Department by which persons can make applications for funding. [28793/04]
View answerThe position is that it is a matter for the health board to determine if the treatment is to be authorised in such circumstances as described by the Deputy. EU Regulations 1408/71 and 574/72 set out the general position for EU-EEA citizens with regard to their health care entitlements in another member state or Switzerland. The regulations outline that persons covered — in Ireland, persons ordinarily resident — are entitled to health care through the public system of another EU-EEA country or Switzerland as though he or she were a resident or insured person of that country where such care becomes necessary during a temporary stay in that country, taking into account the nature of the care and the expected length of stay.
In instances where a person not travelling requires specific necessary treatment, which is not available in the country in which he or she resides, the local health authority may make arrangements to send him or her to another EU member state for treatment under the E112 liaison agreement. Public health care systems vary from country to country such that co-payments may be required in some countries, which are not reimbursable, while health service provision is subject to the same restraints of capacity etc. as for ordinary residents.
In Ireland, the form E112 as issued by a health board, may cover such cases requiring necessary treatment. It is essential for the health board to establish that the patient's requirements cannot be met locally or in any other centre within the State prior to issuing the form. Where an individual requires specific treatment which is necessary and which is not available in Ireland, a health board may authorise the provision of treatment in another member state.
Before any patient is referred abroad for treatment a health board ensures that the following procedures are adhered to: the application to refer a patient abroad must be assessed before the patient goes abroad except in cases of extreme urgency; medical evidence must be provided by a hospital consultant giving details of the condition from which the patient suffers and of the type of treatment envisaged; it must be certified by the consultant that the treatment is not available in this country, there is an urgent medical necessity for the treatment, there is a reasonable medical prognosis, the treatment is regarded as a proven form of medical treatment and the treatment abroad is in a recognised hospital or other institution and is under the control of a registered medical practitioner.
In normal circumstances, it is a matter for the local health board to determine if such treatment is to be authorised. The issue of the E112 form involves a commitment by the health board to pay the cost of treatment. In issuing the form the health board should specify the nature and extent of treatment to be covered. In the case where a person's E112 application has been approved a health board may provide assistance towards the cost of travel and subsistence expenses. The decision in relation to the provision of such assistance is a matter for the relevant health board.
Arrangements which are made privately for the treatment of a patient in any country abroad, must be regarded as outside the terms of the EU regulations and health boards have no obligation to meet any part of the cost involved. In the first instance the individual concerned should be advised to contact their local health board for further advice and guidance on this matter, and in order not to delay a decision on their optimum treatment.
